Prevalence and Clinical Feature of Coagulation Syndrome After Endoscopic Submucosal Dissection for Gastric Neoplasm: 1526

Introduction: Although endoscopic submucosal dissection(ESD) is a well-established procedure characterized by en-bloc resection of gastric neoplasm, there are some complications related to ESD, such as bleeding and perforation. Among them, coagulation syndrome after ESD is not well known because of self-limiting clinical course regardless of their frequency. The aims of this study were to investigate the prevalence and the clinical features of post-ESD coagulation syndrome. Methods: A retrospective analysis was performed in 289 patients who were treated with ESD for gastric neoplasm between May 2012 and September 2014 in our hospital. The patients who presented fever, abdominal pain and abdominal tenderness after ESD without perforation or definite infections were considered as post ESD coagulation syndrome. The patients diagnosed post-ESD coagulation syndrome were analyzed to clarify clinical outcomes. And clinicopathological characteristics related post-ESD coagulation syndrome were examined. Results: There were 13 patients showed coagulation syndrome after ESD for gastric neoplasm. In patients with post-ESD coagulation syndrome, the median duration of pyrexia was 8.6±6.3 hours and the median days of hospitalization were 7.1±3.5 days (vs. 5.8±1.9 days for patients without post-ESD coagulation syndrome). All patients with post-ESD coagulation syndrome were improved in about 1 week with medical treatment, regardless of antibiotics use. There is no statistically significant differences in the demographic, endoscopic and procedure related characteristics such as age, sex, comorbidity, procedure time, coagulation time, size of the lesion, difference in pathology, between the patients with and without post-ESD coagulation syndrome. Conclusion: The incidence of coagulation syndrome after ESD for gastric neoplasm was 4.5%. And patients with post-ESD coagulation syndrome presented favorable clinical course in 1 week. There were no significant predictive factors of post-ESD coagulation syndrome.